Prevention in Practice

On the 50th Anniversary of Maurice Hilleman’s Discovery

The last week of April was World Immunization Week, sponsored by the WHO and its worldwide partners. More than 180 countries, territories, and areas marked the week with activities including vaccination campaigns, training workshops, round-table discussions and public information campaigns. In conjunction, here in California, the Department of Public Health promotes National Infant Immunization Week (NIIW) and Toddler Immunization Month (TIM), annual observances that highlight the importance of routine immunizations for children younger than two years of age.

March was also the 50th anniversary of the first steps in the development of a vaccination for mumps. For the occasion, a New York Times article celebrated the superhero of vaccinations, Maurice Hilleman, an American microbiologist who developed over 36 vaccines, more than any other scientist. Of the 14 vaccines routinely recommended in current vaccine schedules, he developed seven: those for measles, mumps, hepatitis A, hepatitis B, chickenpox, meningitis, and pneumonia. He is often credited with saving more lives than any other scientist of the 20th century. He unquestionably deserves his own wing in the preventive medicine Hall of Fame.

In 1988, Hilleman received the National Medal of Science, the nation’s highest scientific honor. In his lifetime (he died in 2005), he also received: the Prince Mahidol Award from the King of Thailand for the advancement of public health; a special lifetime achievement award from the World Health Organization; the Mary Woodard Lasker Award for Public Service; and the Sabin Gold Medal. Robert Gallo, co-discoverer of the virus that causes AIDS, said “If I had to name a person who has done more for the benefit of human health, with less recognition than anyone else, it would be Maurice Hilleman. Maurice should be recognized as the most successful vaccinologist in history. ”

The use of vaccines to protect, or “immunize” people of all ages against disease is one of the world’s most powerful tools in public health. Immunization is a highly successful and cost-effective preventive intervention, averting between 2 and 3 million deaths every year. From infants to senior citizens, immunization protects against diseases such as diphtheria, measles, pertussis (whooping cough), pneumonia, polio, rotavirus diarrhea, rubella, and tetanus.

Global vaccination coverage is improving: 130 countries have been able to administer all three primary doses of the DPT vaccine to 90% of children younger than 1. And the benefits of immunization are increasingly being extended to adolescents and adults, providing protection against life-threatening diseases such as influenza, meningitis, and cancers (cervical and liver).

Yet even now an estimated 22 million infants are not fully immunized with routine vaccines, and more than 1.5 million children under 5 die from diseases that could be prevented by existing vaccines. There remains an urgent need to better communicate the health benefits of vaccination and the dangers of not immunizing children.

Priority needs to be given to strengthening routine vaccination globally, especially in the countries that are home to the highest number of unvaccinated children (India, Nigeria, and Indonesia). Particular efforts are needed to reach the underserved, especially those in remote areas, in deprived urban settings, in fragile states, and strife-torn regions.

The Global Vaccine Action Plan (GVAP) is a roadmap to prevent millions of deaths through more equitable access to vaccines. Countries are aiming to achieve vaccination coverage of ≥90% nationally and ≥80% in every district by 2020.

An encouraging example is Haiti, which has recently introduced the pentavalent vaccine, a combination vaccine designed to protect children from five dangerous diseases. Haiti is among the countries in the Americas with the highest child mortality rates, caused mainly by acute respiratory infections like pneumonia, diarrheal diseases, anemia, and chronic malnutrition. The “five-in-one” pentavalent vaccine protects children from diphtheria, tetanus, whooping cough, hepatitis B and Haemophilus influenzae type b (Hib), which causes pneumonia and meningitis.

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